H–1Bs for Physicians and the Healthcare Workforce Act

Nursing Home Reform (Better Way) Appropriations related outreach Support of the 21st Century Long-Term Care Caucus Outreach to DOL in Support of LTC Apprenticeships Programs Workforce Related Matters Advocacy around Observations Stays Advocacy around LTC workforce and AL with Senate Aging Committee DOL, Employment and Training - National Apprenticeship Enhancements Train More Nurses Act The American Apprenticeship Act Strengthening Pathways to Health Professions Act Freedom to Invest in Tomorrows Workforce Act States Handling Access to Reciprocity for Employment (SHARE) Act Improving Care and Access to Nurses (I CAN) Act Certified Nursing Assistant (CNA) Workforce Improvement Act The Caring for Seniors Act National Nursing Workforce Center Act Care Across Generations Act HR 1, One Big Beautiful Act Health Care Workforce Expansion Act (S. 2954) The Pathways to Health Careers Act (H.R. 5370) Healthcare Workforce Resilience Act (S. 2759/H.R. 5283) Essential Workers for Economic Advancement Act (H.R. 5494) National Nursing Workforce Center Act (S. 1482/H.R. 4407) Freedom to Invest in Tomorrows Workforce Act (Provisions of bill signed into law in reconciliation package - H.R. 1) Following TPS, H-1B and other immigration related updates from Hill and Admin Health Care Workforce Expansion Act (S. 2954) Physicians and the Healthcare Workforce Act (H. R. 7961) Department of Education NPRM, which includes a proposed change to the definition of what counts as a professional degree Dr. Lorna Breen Health Care Provider Protection Reauthorization Act (H.R. 929/S. 266) Physical Therapist Workforce and Patient Access Act (H.R. 5621) Enhancing Skilled Nursing Facilities Act (H.R. 7106) Healthcare Workforce Resilience Act (S. 2759/H.R.5283) Train More Nurses Act (S. 547/H.R.5052) Dept of Education Final Rule on Student Loan Program DOL Overtime Rule DOL Joint Employer Rule under FSLA Workforce Housing Tax Credit Act (H.R.8626) The Apprenticeship Data Value Improvements to Create Employment (ADVICE) Act The Streamlining Timely Apprenticeship Registration and Transparency (START) Act

Client expense: $830,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), SENATE, State, Dept of (DOS)

HR 7961, the Physicians and Healthcare Workforce Act

Client expense: $10,000 · Firm income: Not reported

Government targets: Education, Dept of, HOUSE OF REPRESENTATIVES

Treatment of pregnant and postpartum people in immigration detention (general); access to medical care in immigration detention (general); H.R. 1061/S. 455, Protecting Sensitive Locations Act; H-1B and J-1 visa delays/disruptions for physicians and trainees (general); H.R. 7961, H-1Bs for Physicians and the Healthcare Workforce Act; H-1B Cap Subject Application Fee

Client expense: $250,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), SENATE

Monitor federal issues and legislation associated with health care policy. Monitor federal and legislative activity related to Medicare reimbursement. Monitor federal and legislative activity related to drug pricing. Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act (HR 929 / S 266) Medicare Patient Access and Practice Stabilization Act (HR 879/ S.1640) Reducing Medically Unnecessary Delays in Care Act (HR 2433) Resident Education Deferred Interest (REDI) Act (HR 2028 / S 942) Help Ensure Lower Patient (HELP) Copays Act (S. 864) Patients Before Middlemen Act (S. 882) PBM Transparency Act (S. 526) Prescription Pricing for the People Act (S. 527) Conrad State 30 and Physician Access Reauthorization Act (HR 1585 / S 709) Resident Physician Shortage Reduction Act (HR.3890/S. 2439) Improving Seniors Timely Access to Care Act (S. 1816/HR. 3514) One Big Beautiful Bill Act (HR. 1) Safe Step Act (HR 5509/S. 668) Patient Access to Autoimmune Treatment, PAAT, Act (HR. 5467) Protecting Patient Access to Cancer and Complex Therapies Act (HR 4299) PBM Reform Act of 2025 (HR 4317) Workforce Mobility Act (S.2031) Specialty Physicians Advancing Rural Care, SPARC, Act (H.R 4681/S. 1380) Connect for Health Act of 2025 (HR 2406/S. 1261) Telehealth Modernization Act (HR 5081/S 2709) House Concurrent Res. 14 establishing congressional budget for FY2025 Department of Labor, HHS, and Education Appropriations Act (S. 2587) Department of Defense Appropriations Act (HR 4016/S. 2572) Seniors Deserve SMARTER Care Act (HR 5940) A bill to require private plans to provide for e-prior auth for drugs (S. 4349) Patient Access to Higher Quality Health Care Act (HR 4002) Biosimilar Red Tape Elimination Act (HR 5526/S. 1954) Medical Foods and Formulas Access Act (HR 5684) Physician Led and Rural Access to Quality Care Act (HR 2191/S. 1390) Claims Data Act, H.R. 4331 Rural Residency Planning and development Act of 2025, H.R. 6468 To exempt H-1B health care workers from the restriction under the Presidential Proclamation entitled "Restriction on Entry of Certain Nonimmigrant Workers", and for other purposes, H.R. 7961 Provider Reimbursement Stability Act, H.R. 8163 PBM Fiduciary Accountability, Integrity, and Reform (FAIR) Act, S.3549 Chronic Care Management Act of 2026ﾠHR 8261 Prior Authorization Reform for Autoimmune & Blood Disorders ActﾠHR 9192 Patient Access to Autoimmune Treatments ActﾠHR 5467 Patients First Act H.R. 9693 Expedited Access to Biosimilars Act H.R. 9661/ S. 1414 Protecting Approved Care Act H.R. 10394 Doctors Not AI Act of 2026 H.R. 10210 Protecting Patients from Automatic Denials Act H.R. 9734

Client expense: $50,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Monitor federal issues and legislation associated with health care policy. Monitor federal and legislative activity related to Medicare reimbursement. Monitor federal and legislative activity related to drug pricing. Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act (HR 929 / S 266) Medicare Patient Access and Practice Stabilization Act (HR 879/ S.1640) Reducing Medically Unnecessary Delays in Care Act (HR 2433) Resident Education Deferred Interest (REDI) Act (HR 2028 / S 942) Help Ensure Lower Patient (HELP) Copays Act (S. 864) Patients Before Middlemen Act (S. 882) PBM Transparency Act (S. 526) Prescription Pricing for the People Act (S. 527) Conrad State 30 and Physician Access Reauthorization Act (HR 1585 / S 709) Resident Physician Shortage Reduction Act (HR.3890/S. 2439) Improving Seniors Timely Access to Care Act (S. 1816/HR. 3514) One Big Beautiful Bill Act (HR. 1) Safe Step Act (HR 5509/S. 668) Patient Access to Autoimmune Treatment, PAAT, Act (HR. 5467) Protecting Patient Access to Cancer and Complex Therapies Act (HR 4299) PBM Reform Act of 2025 (HR 4317) Workforce Mobility Act (S.2031) Specialty Physicians Advancing Rural Care, SPARC, Act (H.R 4681/S. 1380) Connect for Health Act of 2025 (HR 2406/S. 1261) Telehealth Modernization Act (HR 5081/S 2709) House Concurrent Res. 14 establishing congressional budget for FY2025 Department of Labor, HHS, and Education Appropriations Act (S. 2587) Department of Defense Appropriations Act (HR 4016/S. 2572) Seniors Deserve SMARTER Care Act (HR 5940) A bill to require private plans to provide for e-prior auth for drugs (S. 4349) Patient Access to Higher Quality Health Care Act (HR 4002) Biosimilar Red Tape Elimination Act (HR 5526/S. 1954) Medical Foods and Formulas Access Act (HR 5684) Physician Led and Rural Access to Quality Care Act (HR 2191/S. 1390) Claims Data Act, H.R. 4331 Rural Residency Planning and development Act of 2025, H.R. 6468 To exempt H-1B health care workers from the restriction under the Presidential Proclamation entitled "Restriction on Entry of Certain Nonimmigrant Workers", and for other purposes, H.R. 7961 Provider Reimbursement Stability Act, H.R. 8163 PBM Fiduciary Accountability, Integrity, and Reform (FAIR) Act, S.3549 Chronic Care Management Act of 2026ﾠHR 8261 Prior Authorization Reform for Autoimmune & Blood Disorders ActﾠHR 9192 Patient Access to Autoimmune Treatments ActﾠHR 5467 Patients First Act H.R. 9693 Expedited Access to Biosimilars Act H.R. 9661/ S. 1414 Protecting Approved Care Act H.R. 10394 Doctors Not AI Act of 2026 H.R. 10210 Protecting Patients from Automatic Denials Act H.R. 9734

Client expense: $50,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Monitor federal issues and legislation associated with health care policy. Monitor federal and legislative activity related to Medicare reimbursement. Monitor federal and legislative activity related to drug pricing. Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act (HR 929 / S 266) Medicare Patient Access and Practice Stabilization Act (HR 879/ S.1640) Reducing Medically Unnecessary Delays in Care Act (HR 2433) Resident Education Deferred Interest (REDI) Act (HR 2028 / S 942) Help Ensure Lower Patient (HELP) Copays Act (S. 864) Patients Before Middlemen Act (S. 882) PBM Transparency Act (S. 526) Prescription Pricing for the People Act (S. 527) Conrad State 30 and Physician Access Reauthorization Act (HR 1585 / S 709) Resident Physician Shortage Reduction Act (HR.3890/S. 2439) Improving Seniors Timely Access to Care Act (S. 1816/HR. 3514) One Big Beautiful Bill Act (HR. 1) Safe Step Act (HR 5509/S. 668) Patient Access to Autoimmune Treatment, PAAT, Act (HR. 5467) Protecting Patient Access to Cancer and Complex Therapies Act (HR 4299) PBM Reform Act of 2025 (HR 4317) Workforce Mobility Act (S.2031) Specialty Physicians Advancing Rural Care, SPARC, Act (H.R 4681/S. 1380) Connect for Health Act of 2025 (HR 2406/S. 1261) Telehealth Modernization Act (HR 5081/S 2709) House Concurrent Res. 14 establishing congressional budget for FY2025 Department of Labor, HHS, and Education Appropriations Act (S. 2587) Department of Defense Appropriations Act (HR 4016/S. 2572) Seniors Deserve SMARTER Care Act (HR 5940) A bill to require private plans to provide for e-prior auth for drugs (S. 4349) Patient Access to Higher Quality Health Care Act (HR 4002) Biosimilar Red Tape Elimination Act (HR 5526/S. 1954) Medical Foods and Formulas Access Act (HR 5684) Physician Led and Rural Access to Quality Care Act (HR 2191/S. 1390) Claims Data Act, H.R. 4331 Rural Residency Planning and development Act of 2025, H.R. 6468 To exempt H-1B health care workers from the restriction under the Presidential Proclamation entitled "Restriction on Entry of Certain Nonimmigrant Workers", and for other purposes, H.R. 7961 Provider Reimbursement Stability Act, H.R. 8163 PBM Fiduciary Accountability, Integrity, and Reform (FAIR) Act, S.3549 Chronic Care Management Act of 2026ﾠHR 8261 Prior Authorization Reform for Autoimmune & Blood Disorders ActﾠHR 9192 Patient Access to Autoimmune Treatments ActﾠHR 5467 Patients First Act H.R. 9693 Expedited Access to Biosimilars Act H.R. 9661/ S. 1414 Protecting Approved Care Act H.R. 10394 Doctors Not AI Act of 2026 H.R. 10210 Protecting Patients from Automatic Denials Act H.R. 9734

Client expense: $50,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R. 1589: American Dream and Promise Act of 2025 A bill to authorize the cancellation of removal and adjustment of status of certain aliens, and for other purposes (ALL). H.R. 2627 and S. 1233: Keep STEM Talent Act of 2025 A bill to provide lawful permanent resident status for certain advanced STEM degree holders, and for other purposes (ALL). S. 2941: Visa Cap Enforcement Act A bill to discontinue certain exceptions from H-1B nonimmigrant visa numerical limitation (ALL). H.R. 8013: Keep Innovators in America Act A bill to amend the Immigration and Nationality to codify the Optional Practical Training program (ALL). H.R. 7961: H-1Bs for Physicians and the Healthcare Workforce Act A bill to exempt H-1B health care workers from the restriction under the Presidential Proclamation entitled Restriction on Entry of Certain Nonimmigrant Workers, and for other purposes (ALL). S. 4165: Educational Visa Transparency Act of 2026 A bill to require all institutions of higher education receiving Federal assistance to regularly submit information to the Student and Exchange Visitor Information System regarding students, faculty, and administrators who are not United States citizens, or lawful permanent residents (ALL). H.J. Res. 215 and S.J. Res. 213 Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by U.S. Immigration and Customs Enforcement of the Department of Homeland Security relating to Establishing a Fixed Time Period of Admission and an Extension of Stay Procedure for Nonimmigrant Academic Students, Exchange Visitors, and Representatives of Foreign Information Media (ALL) Presidential and executive actions on immigration. Presidential and executive actions on international student and scholar visas.

Client expense: $70,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Transparency FEMA COVID Assistance Funds Save Healthcare Workers Act, H.R.3178 Behavioral health CHGME Health care consolidation, mergers and acquisition H1-B Visas H.R. 9393, Lower Costs, More Transparency Act of 2026 H.R. 9390, Prices on the Wall Act Critical Access Hospital Relief Act (H.R. 538) Rural Hospital Support Act (S. 335) Medicare Advantage Prompt Pay Act (H.R.5454) Protect Our Hospitals Act (H.R. 4807) Resident Physician Shortage Reduction Act of 2025 (H.R. 4731/S.2439) H-1Bs for Physicians and the Healthcare Workforce Act (H.R. 7961) Tax Exempt Hospital Transparency Act (H.R. 9504)

Client expense: $60,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 7961 - Issues related to waiving the application fee for H-1B visas for foreign health care professionals seeking to work in the United States.

Client expense: Not reported · Firm income: $80,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 7961 - Issues related to waiving the application fee for H-1B visas for foreign health care professionals seeking to work in the United States.

Client expense: Not reported · Firm income: $80,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support BRAIN Initiative and VA Neurology Centers of Excellence appropriations; Support H.R. 9693 Patients First Act; Support H.R. 5509/S. 2903 SAFE STEP Act; Support H.R. 3514/S.1816 Seniors Timely Access to Care Act; Support H.R. 929/S. 266 Dr. Lorna Breen Health Care Provider Protection Reauthorization Act; Support H.R. 7961 H-1B Visas for Physicians and the Healthcare Workforce Act; Oppose H.R. 139 Sunshine Protection Act.

Client expense: Not reported · Firm income: $50,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Discretionary funding for the Health Center Program, the National Health Service Corps, and the Teaching Health Centers Graduate Medical Education Program that is funded via the Appropriations measure covering the Departments of Labor, Health and Human Services, Education, and Related Agencies Appropriations for FY 2027 in both the House and the Senate. The Community Health Center Fund reauthorization; this "extender" must be reauthorized by December 31, 2026. Lobbying related to ACH's proposed CHC Value and Innovation Fund; H.R.1 One Big Beautiful Bill Act implementation, specifically state-based operations to implement the Rural Health Transformation Program and Community Engagement Requirements Issues related to CMS Interim Final Rule implementing Community Engagement Requirements & Notice of Proposed Rulemaking for Medicaid Managed Care State Directed Payments and Medicaid Fee-for-Service Targeted Medicaid Practitioner Payments. H.R. 10398, the Community Health Center Reforms Enabling Better Access for Seniors and Elders (CHC REBASE) Act. Medicare/Duals issues including Medicare PPS payments, the PACE program, and telehealth flexibilities in the Medicare program. 340B Drug Pricing Program legislation, including HR 10770, the 340B Rebate Model Delay Act; HR 5244, the SUSTAIN 340B Act; HR 9599, the SECURE 340B Act; the 340B Patients Act (S 2372 & HR 4581); the Community Health Center Drug Pricing Protection Act (HR 7391). Comments and legislative efforts to block 340B Rebate Model Pilot Program efforts and manufacturers efforts to compel claims data Issues and legislation related to the primary care workforce, including the Developing the Community Health Workforce Act (HR8629), the Health Workforce Innovation Act (HR935), H-1Bs for Physicians and the Healthcare Workforce Act (HR7961), the Community TEAMS Act of 2025 (HR3885), funding for Title 7 & Title 8 workforce programs and activities related to a new workforce coalition, The Alliance to Strengthen Americas Health Workforce for the Underserved Issues related to CMMI models and health center participation in value-based care payment arrangements, including MAHA Elevate, ACCESS, and LEAD Issues related to the Health Center Community Transformation Hub Act (Has not been reintroduced in 119th Congress) Issues related to the Trump Administrations stance on community health centers and primary care workforce funding, including the Make America Healthy Again agenda (nutrition and chronic disease management). Legislation being developed by Senator Warnock to establish an HRSA grant program to help Section 330 grantees maintain and modernize mobile units.

Client expense: $65,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Management & Budget (OMB), SENATE, White House Office

Letter to DHS Secretary regarding physician J-1 visas Letter to DHS Secretary for physician exemption to H-1B visa fee H.R. 7961 - H-1Bs for Physicians and the Healthcare Workforce Act Congressional Review Act (CRA) resolution of disapproval regarding a regulation, entitled Establishing a Fixed Time Period of Admission and an Extension of Stay Procedure for Nonimmigrant Academic Students, Exchange Visitors, and Representatives of Foreign Information Media

Client expense: $144,050 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), SENATE

H.R. 7961 - H-1Bs for Physicians and the Healthcare Workforce Act: Provisions regarding H-1B visas for physicians and health care workers. H.R. 6718 - Professional Student Degree Act: Provisions regarding higher student borrowing limits for nursing and other health professions. RIN: 3133-AG07 - Provisions regarding proposed OMB rule on Federal Financial Assistance.

Client expense: $110,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), SENATE

Issues related to H.R. 7961 - H-1Bs for Physicians and the Healthcare Workforce Act.

Client expense: Not reported · Firm income: $80,000

Government targets: HOUSE OF REPRESENTATIVES

Immigration Reform H1B Visas Deferred Action for Childhood Arrivals Optional Practical Training American Dream and Promise Act Great Lakes Authority J-1 Visa Waivers Northern Border Regional Commission Nursing as a STEM-related field Duration of Status H.R. 7961, H-1B for Physicians and the Healthcare Workforce Act

Client expense: $90,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Q3 Lobbying Report (July 1-September 30) HCR FEMA re: COVID-19 related reimbursement Critical Access Hospital Relief Act (H.R. 538) Rural Hospital Support Act (S. 335) Expanding Medical Education Act (H.R. 2106) Preserving Emergency Access in Key Sites Act (H.R. 3778/S.1860) Improving Seniors Timely Access to Care Act (H.R. 3514/S.1816) Prompt and Fair Pay Act (H.R. 4559) Medicare Advantage Prompt Pay Act (H.R.5454) Apples to Apples Comparison Act of 2025 (H.R. 4093) Protect Our Hospitals Act (H.R. 4807) Resident Physician Shortage Reduction Act of 2025 (H.R. 4731/S.2439) H-1Bs for Physicians and the Healthcare Workforce Act (H.R. 7961) Tax Exempt Hospital Transparency Act (H.R. 9504) MMM Graduate Medical Education (GME) funding Telehealth flexibilities and payment Californias Medicaid Hospital Quality Assurance Fee Program Medicaid 340B Restoring Rural Health Act (S. 3047) Rural Hospital Fairness Act (H.R. 5821) Defend Rural Health Act of 2026 (H.R.7409) BUD FY 2026 budget FY 2026 appropriations One Big Beautiful Bill Act (H.R. 1) Submitted Comment Letters Regulatory Comment Letter Re: Medicaid Program; Amending the Indirect Hold Harmless Threshold of Health Care-Related Taxes (CMS-2452-P) Re: Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; and Quality Reporting Programs; Including the Hospital Outpatient Quality Reporting Program and Ambulatory Surgical Center Quality Program; Request for Information on Strengthening the Standardization and Comparability of Hospital Price Transparency (HPT) Data; Prior Authorization; Accrediting Organization (AO) Deeming for Emergency Medical Treatment and Labor Act (EMTALA); and Notices of Closure of Teaching Hospitals and Opportunities To Apply for Available Slots (CMS-1850-P)

Client expense: $370,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Medicare Payment Advisory Commission (MedPAC), SENATE, Social Security Administration (SSA)

Policies and proposals impacting Medicaid managed care organizations, dually eligible special needs plans and PACE programs, including Medicaid eligibility, enrollment, work requirements, state directed payments, and MCO (Managed Care Organization) provider tax issues in H.R.1 - One Big Beautiful Bill Act; Rural Heath Reauthorization legislation; PL 119-4, FY 26 and FY 27 Appropriations legislation, and various Presidential executive orders. Continuing Appropriations and Extensions Act, 2026. H.R. 7961 H1-B Visa Support for Health Care Professionals

Client expense: Not reported · Firm income: $45,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

H.R. 1521 - The DOC Access Act, all provisions H.R.1201 - Doctors in our Borders Act, all provisions H.R.1585 - Conrad State 30 and Physician Access Reauthorization Act, all provisions H.R.5283 - Healthcare Workforce Resilience Act, all provisions H.R.7961 - H-1Bs for Physicians and the Healthcare Workforce Act, all provisions S.2650 - DOCTORS Act, all provisions S.2759 - Healthcare Workforce Resilience Act, all provisions S.4637 - Conrad 30 Physician Workforce Optimization Act, all provisions S.709 - Conrad State 30 and Physician Access Reauthorization Act, all provisions Comment Letter: [USCIS-2026-0298] Fee for Certain H-1B Petitions Alternative pathways to citizenship for foreign international medical graduates Matters related to filing fees for physician H-1B visa holders Matters related to J-1 visa processing for physicians Matters related to Proclamation 10998/Physician exemption Matters related to regulatory changes to duration of status for J-1 physicians. Matters related to exempting physicians from new H1-B visa fees Regulatory changes to processing physician H-1B visas including processing visas for physicians from presidentially banned countries

Client expense: $4,540,000 · Firm income: Not reported

Government targets: Bureau of Citizenship & Immigration Services (BCIS), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), SENATE, State, Dept of (DOS)

H.R.1585/S.709 - Conrad State 30 and Physician Access Reauthorization Act Issue: Support expansion of the Conrad 30 program and improvements to physician immigration. H.R.1201 - Doctors in Our Borders Act Issue: Support expansion of the Conrad 30 program and improvements to physician immigration. Educate Congress on policies allowing undocumented students to attend U.S. medical schools and graduate medical education. S.3348 - Dream Act of 2025 Issue: Support permanent protections for Deferred Action for Childhood Arrivals (DACA) recipients. H.R.7961 - H-1Bs for Physicians and the Healthcare Workforce Act  Issue: Support physician and health industry exemptions from the $100,000 filing fee for new H-1B visa applications included in the Presidential Proclamation entitled Restriction on Entry of Certain Nonimmigrant Workers. Issue: Oppose renewal of Presidential Proclamation 10973, Restriction on Entry of Certain Nonimmigrant Workers, which implements a $100,000 fee for new H-1B specialty worker visa fees for employers to hire a worker. Support a national interest exemption for all of academic medicine and the health care sector. Issue: Oppose the Department of Homeland Security (DHS) proposed rule for a new $103,265 fee on new cap-subject H-1B applications, The extra add-on fee did not previously exist for H-1B cap-subject petitions. Issue: Oppose the Department of Homeland Security (DHS) proposed rule which implements new fees for F-1 foreign students seeking to participate in Optional Practical Training (OPT), a temporary employment authorization connected to a students field of study. The proposed rule would establish a $70,000 fee for F-1 student visas for an initial 12-month OPT and an additional $30,000 fee for a 24-month extension. H.Res.215/S.J.Res.213 - Providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by U.S. Immigration and Customs Enforcement of the Department of Homeland Security (DHS) relating to "Establishing a Fixed Time Period of Admission and an Extension of Stay Procedure for Nonimmigrant Academic Students, Exchange Visitors, and Representatives of Foreign Information Media" Issue: Support the preservation of Duration of Status (D/S) and oppose the Department of Homeland Security (DHS) proposed rule, Establishing a Fixed Time Period of Admission and an Extension of Stay Procedure for Nonimmigrant Academic Students, Exchange Visitors, and Representatives of Foreign Information Media, which would end the current D/S visa term for most F, J, and I visa holders in favor of a fixed term framework, not to exceed four years. Support bicameral Congressional Review Act (CRA) resolution of disapproval regarding the U.S. Immigration and Customs Enforcement (ICE) of the DHS D/S final rule. Issue: Oppose the Department of Homeland Securitys (DHS) interim final rule with comment period, Removal of the Automatic Extension of Employment Authorization Documents, which ends automatic extensions of work authorization of certain Employment Authorization Documents (EADs) when EAD renewal applications are timely filed for international medical graduates (IMGs). Issue: Support exemptions for nonimmigrant visas, including F, J, and M student visas, from countries included under the Presidential Proclamation Restricting the Entry of Foreign Nationals to Protect the United States from Foreign Terrorists and other National Security and Public Safety Threats and any future travel bans offered by the Administration. Issue: Educate Congress on impact of U.S. Citizenship and Immigration Services (USCIS) memo that would alter adjustment of status applications. H.R.8943 - Our Doctors First Act of 2026 Issue: Oppose legislation that prohibits Medicare support for graduate medical education (GME) for non-citizens. H.R.8942 - GME Transparency Act of 2026 Issue: Oppose legislation that would condition medical residency program status on hospital and health system reporting of resident citizenship, visa, and immigration status.

Client expense: $431,446 · Firm income: Not reported

Government targets: Bureau of Citizenship & Immigration Services (BCIS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health Resources & Services Administration (HRSA), Homeland Security, Dept of (DHS), SENATE, State, Dept of (DOS), White House Office

S 709/HR 1585, the Conrad State 30 and Physician Access Reauthorization Act, HR 5283/S 2759, Healthcare Workforce Resilience Act; HR 7961, H-1Bs for Physicians and Healthcare Workforce Act

Client expense: Not reported · Firm income: $80,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 709/HR 1585, the Conrad State 30 and Physician Access Reauthorization Act; S 2650, the DOCTORS Act; HR 5283/S 2759, Healthcare Workforce Resilience Act;; HR 7961, H-1Bs For Physicians and the Healthcare Workforce Act

Client expense: Not reported · Firm income: $40,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Issues related to H.R. 7961 - H-1Bs for Physicians and the Healthcare Workforce Act.

Client expense: Not reported · Firm income: $110,000

Government targets: HOUSE OF REPRESENTATIVES

Resident Physician Shortage Reduction Act, H.R. 4731 / S. 2439 Conrad State 30 and Physician Access Reauthorization Act, H.R. 1585/S. 709 Resident Education Deferred Interest Act, H.R. 2028 / S. 942 Safe Step Act, H.R. 5509 / S. 2903 - Improving Seniors Timely Access to Care Act, H.R. 3514 / S. 1816 H-1Bs for the Physicians and Healthcare Workforce Act, H.R. 7961 Urging support for and the bolstering of the neurology workforce Urging reforms to proposed surprise billing regulations to align with congressional intent for payment disputes. Medical research funding related to NIH including the BRAIN Initiative, NINDS, ARPA-H, NIA - Issues related to animal testing in medical research Seeking exemption for physicians and other health professionals from increased H-1B fees Requesting national interest exceptions and expedited processing for physicians and medical trainees for entering and maintaining legal residency in the United States

Client expense: $270,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Natl Institutes of Health (NIH), SENATE, State, Dept of (DOS), Veterans Affairs, Dept of (VA)

Support revisions to Conrad 30 waiver program to increase the number of foreign physicians that may remain in the US after completing GME: S.665/H.R.4942, S.2719/H.R.6980, H.R. 4875. Discuss RIN 1653-AB01, DHS Proposed Rule - Optional Practical Training Fees. Oppose $100,000 fee for H-1B visa applications: Oppose September 19 Presidential Proclamation imposing $100,000 fee; support health care sector exemption; support H-1Bs for Physicians and the Healthcare Workforce Act (H.R. 7961). Discuss RIN 1615-AD20, Fee for Certain H-1B Petitions, and support exemption for cap-exempt institutions. Discuss H.R.1689, designating Haiti for Temporary Protected Status.

Client expense: $550,000 · Firm income: Not reported

Government targets: Bureau of Citizenship & Immigration Services (BCIS), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), SENATE

Congressional outreach and monitoring regarding the following: -H.R. 3178/S.1600, Save Healthcare Workers Act. -H.R. 9504, Tax Exempt Hospital Transparency Act. -H.R. 9599, SECURE 340B Act. -H.R. 7961, H-1Bs for Physicians and the Healthcare Workforce Act. -H.R. 5269/S. 2761, RESULTS ACT. -S.4994, ONSHORE Manufacturing Act. -340B policy issues. -Site Neutral Payment Proposals. -Healthcare and hospital workforce budget and appropriations, generally. -Medicare and Medicaid reimbursements.

Client expense: $30,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Congressional outreach and monitoring regarding the following: -H.R. 3178/S.1600, Save Healthcare Workers Act. -H.R. 9504, Tax Exempt Hospital Transparency Act. -H.R. 9599, SECURE 340B Act. -H.R. 7961, H-1Bs for Physicians and the Healthcare Workforce Act. -H.R. 5269/S. 2761, RESULTS ACT. -S.4994, ONSHORE Manufacturing Act. -340B policy issues. -Site Neutral Payment Proposals. -Healthcare and hospital workforce budget and appropriations, generally. -Medicare and Medicaid reimbursements.

Client expense: $30,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H-1Bs for Physicians and Healthcare Workforce Act (H.R. 7961).

Client expense: $850,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES

ACPs 2026 Third Quarter Lobbying Disclosure Report Medicare Payments to Physicians: Sent letter and met with legislators in support of the Patients First Act of 2026, (H.R. 9693) for a Medicare Economic Index inflationary updated to the physician fee schedule for physician practices, support for independent practices and replacement of MIPS with POINTS for quality measures. Supported and urged Congress to pass (H.R. 8163, S.5180), the Provider Reimbursement Stability Act, to enhance Medicare reimbursement stability for physicians by modernizing the Medicare Physician Fee Schedule. The Provider Reimbursement Stability Act of 2026. H.R. 8163 would raise the budget neutrality threshold from $20 million to $57.64 million and would use cumulative increases in the Medicare Economic Index (MEI) to update the threshold every 5 years. ACP supported the Medicare Physician Data-Drive Performance Payment System Act of 2026, H.R. 8622. This critical legislation seeks to modernize Medicare payments by reducing administrative burdens, improving patient care, and supporting small/rural practices through a more practical, data-driven approach. Dr. William Fox, Chair Emeritus of ACPs Board of Regents, testified before the House Energy and Commerce Committees Health Subcommittee on policy reforms to improve the Medicare Physician Fee Schedule and the Medicare Access and CHIP Reauthorization Act (MACRA) on behalf of ACP. Dr. Rebecca Andrews, Past Chair of ACPs Board of Regents, testified before the House E&C Health Subcommittee in favor of each of the bills mentioned above. ACP supported Pay PCPs Act of 2026 (S. 5269), to inject $10 billion federal investment from fiscal year 2027 through 2031 to provide for the establishment of hybrid primary care payments under Medicare. Support Value-Based Care: Urged reintroduction and support of the Value in Health Care Act of 2024. The bill provides a multi-year commitment to reforming care delivery by extending MACRAs 5 percent advanced alternative payment models (APM) incentives that expired at the end of 2024. ACP supported the Preserving Patient Access to Accountable Care Act which aligns with Colleges policy to support the transition to value-based payments through alternative payment models (APMs) that can accommodate a wide range of specialties, practice sizes, and unique patient populations. ACP supported this legislation as it would extend the incentive payments for qualifying physicians and other clinicians to participate in Medicare advanced APMs through payment year 2027 at an increased amount of 3.53 percent and would freeze the scheduled increase in qualifying thresholds. Pricing Transparency/Consolidation: Provided comments to the House Energy and Commerce Committees markup, which includes the Lower Cost, More Transparency Act, H.R. 9393, and the Improving Seniors Timely Access to Care Act, H.R. 3514. The two bills would enhance price transparency across health care entities and streamline unnecessary administrative burden, respectively. ACP also supported several policies included in bills slated for markup that would reform Medicare Advantage practices to ensure accountability and safeguard market competition. ACP strongly supports pricing transparency in health care. ACP supported the passage of the Lower Costs, More Transparency Act, which passed the House in the 118th Congress, and we continue to support its reintroduction and passage in this Congress under H.R. 9393. ACP supported provisions within the Medicare Advantage Cost Transparency Act, H.R. 9392, led by Ranking Member DeGette and Dr. Joyce, which would provide greater oversight by requiring that Medicare Advantage (MA) plans report to the Centers for Medicare & Medicaid Services (CMS) on encounter data, including the allowed amount that a plan agreed to pay for a service in total and the total out-of-pocket costs the patient pays for a service. The College has repeatedly voiced support for the Improving Seniors' Timely Access to Care Act, led by Reps. Kelly and DelBene, which would protect patients from unnecessary delays in care and reduce administrative burden on physicians by streamlining MAs prior authorization approval processes. We urge Congress to pass H.R. 3514 to ensure that our patients will get the care they need, when they need it most. FY2026 Appropriations/Agency Restructuring: For FY2027, ACP is urged appropriations committees that funding be either maintained or increased for the following proven programs: 1) Health Resources Services Administration (HRSA), $10.5 billion, including: 2) Health Workforce, National Health Service Corps (NHSC), $915.6 million in total program funding; 3) Primary Care Training and Enhancement (PCTE), $71 million; 4) Title X Family Planning Program, $390 million; 5) Agency for Healthcare Research and Quality (AHRQ), $500 million; 6) Centers for Disease Control and Prevention (CDC) Injury Prevention and Control, $11.6 billion, including: 7) Firearm Injury and Mortality Prevention Research, $35 million; 8) Chronic Disease Prevention and Health Promotion, Social Determinants of Health, $100 million; 9) National Institutes of Health (NIH), $51.3 billion, including: 10) Office of the Director, Firearms Research, $25 million; 11) Centers for Medicare and Medicaid Services (CMS) and Government Accountability Office (GAO); and 12) Report language to ensure primary care physicians are receiving Medicare physician revaluations. We urged Congress to include report language in the FY2026 Labor HHS appropriations bill to direct the GAO to conduct a study encompassing the last decade of CMS estimates of new and revised code utilizations. ACP believes CMS has overestimated utilizations, thus adversely affecting available funds in the Medicare physician fee schedule for other code usage. While the House and Senate bills included language, we prefer the stronger House version language and hope Congress will pass the FY26 Labor HHS bills. Also urged Congress to include report language in the FY2027 Labor HHS appropriations bill directing a study on extent G2211 add on codes and increases in fee schedule for primary care are being retained by hiring entities (hospitals, ACOs, private equity) versus the physicians. ACP urged appropriators to provide $35 million for the U.S. Centers for Disease Control and Prevention (CDC), $25 million for the National Institutes of Health (NIH), and $1 million for the National Institute of Justice (NIJ) to conduct public health research into firearm morbidity and mortality prevention. Primary Care and the Physician Workforce: ACP urged Congress to support the Resident Physician Shortage Reduction Act of 2025 (S. 2439/ H.R. 4731), which would increase the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions by 14,000 over seven years. ACP supported the Conrad State 30 and Physician Access Reauthorization Act, S. 709 and H.R. 1585, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement. We supported the Resident Education Deferred Interest (REDI) Act (S 942/HR 2028) that, if passed, will allow borrowers to qualify for interest-free deferment on their student loans while serving in a medical or dental internship or residency program. ACP supported legislation for the H-1Bs for Physicians and Healthcare Workforce Act, H.R. 7961. The bill's primary goal is to exempt healthcare professionals from a $100,000 H-1B visa filing fee. ACP supported H.R. 8765, the Prioritizing Primary Care Act. This legislation would mandate an annual report on federal spending on primary care as well as establish a working group to study and make recommendations on how each federal agency addresses the issue. Scope of Practice: ACP provided comments urging the House Ways and Means Committee during markup to oppose the Equitable Community Access to Pharmacist Services Act, which would expand Medicare coverage to permanently include select services provided by a pharmacist. ACP advocated before Senate offices against the marked-up bill coming out of House Ways and Means and renamed the Main Street Pharmacy Access Act enabling pharmacists to bill certain Medicare codes and to diagnose and treat flu, strep throat and other respiratory infections. Expand Patient Access: We urged Congress to reintroduce and pass the Chronic Care Management Improvement Act. This legislation would have removed the cost sharing requirement for patients to access chronic care management services. We also support allowing the physician that performs chronic care management services to waive the requirement that the patient pay the 20 percent coinsurance fee associated with this service. We urged Congress to protect the public health infrastructure, recognize evidence-based science and preserve healthcare agency staffing to inform and protect the public from infectious disease and other health emergencies. Incidences of previously well-controlled, vaccine-preventable diseases, such as pertussis (whooping cough) and measles, are increasing in the United States. Vaccines are vital to our ability to prevent diseases that threaten public health, including novel diseases and future pandemics. We urged Congress to utilize the best possible scientific evidence to guide public health legislation. It is critical that public health leaders support evidence-based medicine, including the use of vaccines and other effective public health strategies that protect the public. ACP conducted a Hill Briefing on using scientifically driven, evidenced-based vaccines. Clinical Labs: Supported the provision in H.R. 6366 that would delay payment reductions and data reporting periods for the Clinical Laboratory Fee Schedule under the Protecting Access to Medicare Act (PAMA). Legislation could improve patient access to laboratory tests used to diagnose, monitor, prevent, and manage diseases for Medicare beneficiaries. Prescription Drug Reform: Supported the Capping Prescription Costs Act, introduced by Senator Raphael Warnock. The legislation would lower prescription drug costs for millions of Americans by placing annual caps on out-of-pocket costs for prescription drugs at $2,000 for individuals and $4,000 for families with private insurance. Supported bipartisan Drug-price Transparency for Consumers (DTC) Act, a bill that would require price disclosures on advertisements for prescription drugs in order to empower patients and reduce Americans colossal spending on medications. The bill was introduced by Senators Dick Durbin and Chuck Grassley. ACP also supported the Saving Seniors Money on Prescriptions Act, H.R. 950, which aims to drive down the rising costs of prescription drugs for patients on Medicare by improving price transparency in Pharmacy Benefit Managers (PBMs) business practices. Urged Congress to reintroduce and pass: 1) the Lowering Drug Costs for American Families Act, to expand the number of prescription drugs which Medicare can negotiate under the Inflation Reduction Act from 20 to 50 starting in 2029; 2) the Medicare PBM Accountability Act, legislation aimed at lowering the costs of prescription drugs for seniors covered by Medicare Part D and Medicare Advantage plans; 3) the Increasing Access to Biosimilars Act of 2023, legislation which would encourage adoption of biosimilars in Medicare and improve biosimilar accessibility, by establishing a new pilot program - a voluntary, shared savings demonstration program - for providers of biosimilars in Medicare Part B; 4) the Cutting Copays Act, legislation which would eliminate cost-sharing for generic drugs for LIS beneficiaries, helping to incentivize the use of generic drugs; and the Drug Shortage Prevention Act of 2023, which would require that manufacturers of over-the-counter and prescription drugs notify Food & Drug Administration when they are unlikely to meet demand. ACP supported legislation, Drug-Price Transparency for Consumers (DTC) Act, by Senators. Durbin and Grassley that requires Direct-to-Consumer advertisements for prescription drugs and biological products paid for by Medicare and Medicaid to include the list price or Wholesale Acquisition Cost (WAC) for a 30-month supply-which is the price set by manufacturers (and which is paid by uninsured patients, as well as the 50 percent of patients with high-deductible plans).

Client expense: $86,880 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), President of the U.S., SENATE, State, Dept of (DOS), Veterans Affairs, Dept of (VA)

ACPSs 2026 Third Quarter Lobbying Disclosure Report Medicare Payments to Physicians: Sent letter and met with legislators in support of the Patients First Act of 2026, (H.R. 9693) for a Medicare Economic Index inflationary updated to the physician fee schedule for physician practices, support for independent practices and replacement of MIPS with POINTS for quality measures. Supported and urged Congress to pass (H.R. 8163, S.5180), the Provider Reimbursement Stability Act, to enhance Medicare reimbursement stability for physicians by modernizing the Medicare Physician Fee Schedule. The Provider Reimbursement Stability Act of 2026. H.R. 8163 would raise the budget neutrality threshold from $20 million to $57.64 million and would use cumulative increases in the Medicare Economic Index (MEI) to update the threshold every 5 years. ACP supported the Medicare Physician Data-Drive Performance Payment System Act of 2026, H.R. 8622. This critical legislation seeks to modernize Medicare payments by reducing administrative burdens, improving patient care, and supporting small/rural practices through a more practical, data-driven approach. Dr. William Fox, Chair Emeritus of ACPs Board of Regents, testified before the House Energy and Commerce Committees Health Subcommittee on policy reforms to improve the Medicare Physician Fee Schedule and the Medicare Access and CHIP Reauthorization Act (MACRA) on behalf of ACP. Dr. Rebecca Andrews, Past Chair of ACPs Board of Regents, testified before the House E&C Health Subcommittee in favor of each of the bills mentioned above. ACP supported Pay PCPs Act of 2026 (S. 5269), to inject $10 billion federal investment from fiscal year 2027 through 2031 to provide for the establishment of hybrid primary care payments under Medicare. Support Value-Based Care: Urged reintroduction and support of the Value in Health Care Act of 2024. The bill provides a multi-year commitment to reforming care delivery by extending MACRAs 5 percent advanced alternative payment models (APM) incentives that expired at the end of 2024. ACP supported the Preserving Patient Access to Accountable Care Act which aligns with Colleges policy to support the transition to value-based payments through alternative payment models (APMs) that can accommodate a wide range of specialties, practice sizes, and unique patient populations. ACP supported this legislation as it would extend the incentive payments for qualifying physicians and other clinicians to participate in Medicare advanced APMs through payment year 2027 at an increased amount of 3.53 percent and would freeze the scheduled increase in qualifying thresholds. Pricing Transparency/Consolidation: Provided comments to the House Energy and Commerce Committees markup, which includes the Lower Cost, More Transparency Act, H.R. 9393, and the Improving Seniors Timely Access to Care Act, H.R. 3514. The two bills would enhance price transparency across health care entities and streamline unnecessary administrative burden, respectively. ACP also supported several policies included in bills slated for markup that would reform Medicare Advantage practices to ensure accountability and safeguard market competition. ACP strongly supports pricing transparency in health care. ACP supported the passage of the Lower Costs, More Transparency Act, which passed the House in the 118th Congress, and we continue to support its reintroduction and passage in this Congress under H.R. 9393. ACP supported provisions within the Medicare Advantage Cost Transparency Act, H.R. 9392, led by Ranking Member DeGette and Dr. Joyce, which would provide greater oversight by requiring that Medicare Advantage (MA) plans report to the Centers for Medicare & Medicaid Services (CMS) on encounter data, including the allowed amount that a plan agreed to pay for a service in total and the total out-of-pocket costs the patient pays for a service. The College has repeatedly voiced support for the Improving Seniors' Timely Access to Care Act, led by Reps. Kelly and DelBene, which would protect patients from unnecessary delays in care and reduce administrative burden on physicians by streamlining MAs prior authorization approval processes. We urge Congress to pass H.R. 3514 to ensure that our patients will get the care they need, when they need it most. FY2026 Appropriations/Agency Restructuring: For FY2027, ACP is urged appropriations committees that funding be either maintained or increased for the following proven programs: 1) Health Resources Services Administration (HRSA), $10.5 billion, including: 2) Health Workforce, National Health Service Corps (NHSC), $915.6 million in total program funding; 3) Primary Care Training and Enhancement (PCTE), $71 million; 4) Title X Family Planning Program, $390 million; 5) Agency for Healthcare Research and Quality (AHRQ), $500 million; 6) Centers for Disease Control and Prevention (CDC) Injury Prevention and Control, $11.6 billion, including: 7) Firearm Injury and Mortality Prevention Research, $35 million; 8) Chronic Disease Prevention and Health Promotion, Social Determinants of Health, $100 million; 9) National Institutes of Health (NIH), $51.3 billion, including: 10) Office of the Director, Firearms Research, $25 million; 11) Centers for Medicare and Medicaid Services (CMS) and Government Accountability Office (GAO); and 12) Report language to ensure primary care physicians are receiving Medicare physician revaluations. We urged Congress to include report language in the FY2026 Labor HHS appropriations bill to direct the GAO to conduct a study encompassing the last decade of CMS estimates of new and revised code utilizations. ACP believes CMS has overestimated utilizations, thus adversely affecting available funds in the Medicare physician fee schedule for other code usage. While the House and Senate bills included language, we prefer the stronger House version language and hope Congress will pass the FY26 Labor HHS bills. Also urged Congress to include report language in the FY2027 Labor HHS appropriations bill directing a study on extent G2211 add on codes and increases in fee schedule for primary care are being retained by hiring entities (hospitals, ACOs, private equity) versus the physicians. ACP urged appropriators to provide $35 million for the U.S. Centers for Disease Control and Prevention (CDC), $25 million for the National Institutes of Health (NIH), and $1 million for the National Institute of Justice (NIJ) to conduct public health research into firearm morbidity and mortality prevention. Primary Care and the Physician Workforce: ACP urged Congress to support the Resident Physician Shortage Reduction Act of 2025 (S. 2439/ H.R. 4731), which would increase the number of Medicare supported direct graduate medical education (DGME) and indirect medical education (IME) positions by 14,000 over seven years. ACP supported the Conrad State 30 and Physician Access Reauthorization Act, S. 709 and H.R. 1585, to allow states to sponsor foreign-trained physicians to work in medically underserved areas in exchange for a waiver of the physicians' two-year foreign residence requirement. We supported the Resident Education Deferred Interest (REDI) Act (S 942/HR 2028) that, if passed, will allow borrowers to qualify for interest-free deferment on their student loans while serving in a medical or dental internship or residency program. ACP supported legislation for the H-1Bs for Physicians and Healthcare Workforce Act, H.R. 7961. The bill's primary goal is to exempt healthcare professionals from a $100,000 H-1B visa filing fee. ACP supported H.R. 8765, the Prioritizing Primary Care Act. This legislation would mandate an annual report on federal spending on primary care as well as establish a working group to study and make recommendations on how each federal agency addresses the issue. Scope of Practice: ACP provided comments urging the House Ways and Means Committee during markup to oppose the Equitable Community Access to Pharmacist Services Act, which would expand Medicare coverage to permanently include select services provided by a pharmacist. ACP advocated before Senate offices against the marked-up bill coming out of House Ways and Means and renamed the Main Street Pharmacy Access Act enabling pharmacists to bill certain Medicare codes and to diagnose and treat flu, strep throat and other respiratory infections. Expand Patient Access: We urged Congress to reintroduce and pass the Chronic Care Management Improvement Act. This legislation would have removed the cost sharing requirement for patients to access chronic care management services. We also support allowing the physician that performs chronic care management services to waive the requirement that the patient pay the 20 percent coinsurance fee associated with this service. We urged Congress to protect the public health infrastructure, recognize evidence-based science and preserve healthcare agency staffing to inform and protect the public from infectious disease and other health emergencies. Incidences of previously well-controlled, vaccine-preventable diseases, such as pertussis (whooping cough) and measles, are increasing in the United States. Vaccines are vital to our ability to prevent diseases that threaten public health, including novel diseases and future pandemics. We urged Congress to utilize the best possible scientific evidence to guide public health legislation. It is critical that public health leaders support evidence-based medicine, including the use of vaccines and other effective public health strategies that protect the public. ACP conducted a Hill Briefing on using scientifically driven, evidenced-based vaccines. Clinical Labs: Supported the provision in H.R. 6366 that would delay payment reductions and data reporting periods for the Clinical Laboratory Fee Schedule under the Protecting Access to Medicare Act (PAMA). Legislation could improve patient access to laboratory tests used to diagnose, monitor, prevent, and manage diseases for Medicare beneficiaries. Prescription Drug Reform: Supported the Capping Prescription Costs Act, introduced by Senator Raphael Warnock. The legislation would lower prescription drug costs for millions of Americans by placing annual caps on out-of-pocket costs for prescription drugs at $2,000 for individuals and $4,000 for families with private insurance. Supported bipartisan Drug-price Transparency for Consumers (DTC) Act, a bill that would require price disclosures on advertisements for prescription drugs in order to empower patients and reduce Americans colossal spending on medications. The bill was introduced by Senators Dick Durbin and Chuck Grassley. ACP also supported the Saving Seniors Money on Prescriptions Act, H.R. 950, which aims to drive down the rising costs of prescription drugs for patients on Medicare by improving price transparency in Pharmacy Benefit Managers (PBMs) business practices. Urged Congress to reintroduce and pass: 1) the Lowering Drug Costs for American Families Act, to expand the number of prescription drugs which Medicare can negotiate under the Inflation Reduction Act from 20 to 50 starting in 2029; 2) the Medicare PBM Accountability Act, legislation aimed at lowering the costs of prescription drugs for seniors covered by Medicare Part D and Medicare Advantage plans; 3) the Increasing Access to Biosimilars Act of 2023, legislation which would encourage adoption of biosimilars in Medicare and improve biosimilar accessibility, by establishing a new pilot program - a voluntary, shared savings demonstration program - for providers of biosimilars in Medicare Part B; 4) the Cutting Copays Act, legislation which would eliminate cost-sharing for generic drugs for LIS beneficiaries, helping to incentivize the use of generic drugs; and the Drug Shortage Prevention Act of 2023, which would require that manufacturers of over-the-counter and prescription drugs notify Food & Drug Administration when they are unlikely to meet demand. ACP supported legislation, Drug-Price Transparency for Consumers (DTC) Act, by Senators. Durbin and Grassley that requires Direct-to-Consumer advertisements for prescription drugs and biological products paid for by Medicare and Medicaid to include the list price or Wholesale Acquisition Cost (WAC) for a 30-month supply-which is the price set by manufacturers (and which is paid by uninsured patients, as well as the 50 percent of patients with high-deductible plans).

Client expense: $119,057 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), President of the U.S., SENATE, State, Dept of (DOS), Veterans Affairs, Dept of (VA)

Health care quality; physician and hospital quality; health care innovation; Patient Protection and Affordable Care Act/health care reform implementation; unique device identifier policy and post-market surveillance for medical devices; clinical trial design; HIPAA and registries; federal funding/appropriations for HHS, NIH, AHRQ, CDC, FDA, HRSA and the Childrens Hospital Graduate Medical Education payment program, the Prevention & Public Health Fund, medical research, and prevention; research and scholarly communication policy; implementation and oversight of 21st Century Cures Act; data blocking/interoperability of electronic data; artificial intelligence/machine learning; algorithm transparency; health disparities; reduction/oversight of prior authorization and other administrative burdens; digital health; Sect. 1557 Nondiscrimination in Health Programs and Activities; cardiomyopathy education and awareness; peripheral arterial disease (PAD) education and awareness; VA Mission Act implementation; COVID-19 and implementation of the Coronavirus Preparedness and Response Supplemental Appropriations Act, the Families First Coronavirus Response Act , the Coronavirus Aid, Relief, and Economic Security Act, Coronavirus Provider Protection Act, and clinician mental health and wellbeing; patient identification; Pandemic and All Hazards Preparedness; RAPID coverage program and Breakthrough Device policy; Amputation Reduction and Compassion (ARC) Act (H.R. 307); Resident Education Deferred Interest (REDI) Act (H.R. 2028/S. 942); Implementation and funding for the Cardiomyopathy Health, Education, Awareness, Research and Training in Schools (HEARTS) Act (P.L. 118-176); provide AEDs in transportation facilities with the Public Access to Defibrillation in Transportation Facilities Act (H.R. 5897); Residential AED and CPR Preparedness Act of 2026 (H.R. 9058); Lorna Breen Health Care Provider Protection Reauthorization Act (H.R. 929/S. 266; Physician Led and Rural Access to Access to Quality Care Act (H.R. 2191/S. 1390); Section 232, National Security Investigation of Imports of Pharmaceuticals and Pharmaceutical Ingredients; and to protect health care workers from violence with the Save Healthcare Workers Act (H.R. 3178/S. 1600), Front of Package Food Labeling, The Medically Tailored Home-Delivered Meals Program Pilot Act (H.R. 5439/S. 2834); The Nursing is a Professional Degree Act (H.R. 8691/S. 4568), H.R.9260 - Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2027; and the H-1Bs for Physicians and the Healthcare Workforce Act (H.R. 7961); Protecting Patients from Automated Denials Act (H.R. 9734); and the Doctors Not AI Act (H.R. 101210).

Client expense: $600,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Commerce, Dept of (DOC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, White House Office

Graduate Medical Education Certified Anesthesiologist Assistants Anesthesia workforce shortages HR 3890, Resident Physician Shortage Reduction Act of 2025: residency positions S.709, Conrad State 30 and Physician Access Reauthorization Act: Foreign physician immigration status S. 1380, Specialty Physicians Advancing Rural Care (SPARC) Act: physician shortages in rural areas HR 2028; Resident Education Deferred Interest Act (REDI Act): Student loan relief Anesthesia Research Funding Scope of Practice Merit-based Incentive Payment System, MIPS, MIPS Value Pathway Quality Payment Program, QPP Alternative Payment Model, APM QCDR - Qualified Clinical Data Registry Evaluation and Monitoring codes & cuts Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Brain health CMS Interpretive Guidelines: Hospital Conditions of Participation Related to Anesthesia Services Conditions of Participation - Anesthesia services, opt-outs, supervision CMS: Federal Independent Dispute Resolution (IDR) Process, Batching H.R.27, HALT Fentanyl Act: fentanyl scheduling and registration requirements H.R. 1227/S.475, Alternatives to PAIN Act of 2025: access to non-opioid pain management options Pain Medicine Prescription Drug Abuse CDC Opioid Prescribing Guideline H.R. 3595, Safe Prescribing Through Reporting Act of 2025: disclosure of certain records relating to substance use disorder medications to State prescription drug monitoring programs Drug shortages DEA Scheduling Propofol FDA Safe Use Initiative FDA Operating Room Fires FDA Opioids FDA Network of Experts FDA Nominations to Advisory Committees (Anesthesia Drugs, Anesthesia Devices, Compounding) USP - US Pharmacopeia Compounding NIH Interagency Pain Research Coordinating Committee NIH: Funding, Indirect Costs, Indirect Grants, Overhead Agency for Healthcare Research and Quality (AHRQ) funding Long COVID research 21st Century Cures Initiative Out of Network/Out of Network Payment Network Adequacy Pre-authorization; prior authorization Insurance reform, shared savings, insurer accountability Affordable Care Act reform efforts Provider Nondiscrimination Change Healthcare, Change Healthcare data breach HR 292 Lorna Breen Reauthorization H.R. 3178, SAVE Healthcare Workers Act: To protect hospital personnel from violence, and for other purposes Maternal Mortality/Maternal Care Deserts Blood management 42 CFR Part 2, Confidentiality of Substance Use Disorder Patient Records: appropriate access to patient information essential for providing whole-person care S. 2759/H.R. 5283, the Healthcare Workforce Resilience Act, Exemption for Physicians from New H-1B Visa Policy and $100,000 Fee Medical journal fees No Surprises Act (NSA) - H.R.4710 / S. 2420, the No Surprises Enforcement Act H.R. 3164, the Ensuring Community Access to Pharmacist Services Act Advance Premium Tax Credits (APTCs) Federal regulation of commercial health insurance companies One Big Beautiful Bill (OBBB) Commercial payer/payment H.R.7961: H-1Bs for Physicians and the Healthcare Workforce Act S.3822: Breaking Up Big Medicine Act H.R. 4681: Specialty Physicians Advancing Rural Care (SPARC) Act Low-carbon anesthesia OMB Proposed Rule on federal funding / grants U.S. Departments of State and Homeland Security Visa delays Venezuelan patients Pain management in C-sections DEA Regulations Controlled Substances Act Amendments

Client expense: $270,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Defense, Dept of (DOD), Drug Enforcement Administration (DEA), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Justice, Dept of (DOJ), Natl Institutes of Health (NIH), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

Issues related to the Departments of Labor, Health and Human Services, Education, and Related Agencies Appropriations for FY 2027, including written testimony to the U.S. House Appropriations Committee and U.S. Senate Appropriations Committee subcommittees on Labor, Health and Human Services, Education, and Related Agencies on CHC Funding H.R.1 One Big Beautiful Bill Act implementation, specifically state-based operations to implement the Rural Health Transformation Program Issues related to CMS Interim Final Rule implementing Community Engagement Requirements & Notice of Proposed Rulemaking for Medicaid Managed Care State Directed Payments and Medicaid Fee-for-Service Targeted Medicaid Practitioner Payments 340B Drug Pricing Program legislation, including the SUSTAIN Act, 340B Patients Act (HR 4581), the Community Health Center Drug Pricing Protection Act (HR 7391), and proposed 340C legislation Comments and legislative efforts to block 340B Rebate Model Pilot Program efforts and manufacturers efforts to compel claims data Statement submitted to the House Committee on Budgets hearing, Reverse the Curse: Skyrocketing Health Care Costs and Americas Fiscal Future Issues and legislation related to the primary care workforce, including introduction of the Developing the Community Health Workforce Act (HR8629), the Health Workforce Innovation Act (HR935), H-1Bs for Physicians and the Healthcare Workforce Act (HR7961), the Community TEAMS Act of 2025 (HR3885), funding for Title 7 & Title 8 workforce programs and activities related to a new workforce coalition, The Alliance to Strengthen Americas Health Workforce for the Underserved Issues related to CMMI models and health center participation in value-based care payment arrangements, including MAHA Elevate, ACCESS, and LEAD Issues related to the Health Center Community Transformation Hub Act (Has not been reintroduced in 119th Congress) Issues related to the Trump Administrations stance on community health centers and primary care workforce funding, including the Make America Healthy Again agenda (nutrition and chronic disease management) and the Presidents proposed budget

Client expense: $85,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Office of Management & Budget (OMB), SENATE, White House Office

Funding for WIC SNAP/Farm Bill Mental Health for Children MODERN WIC Act/21st Century WIC Act Breastfeeding Peer Counseling Program Funding for HRSA Pediatric Mental Health Care Access Program Donor Milk Dietary Guidelines Suicide Prevention School Meal Standards WIC Food Packages Whole Milk Supporting Childrens Mental Health Care Access Mental Health Parity Prevention and Early Intervention Set-Aside in Mental Health Block Grant Improving Mental Health and Wellness in Schools Infant Formula Safety Opioid Overdose Prevention 988 Suicide and Crisis Lifeline Mental Health Medication Prescribing Child passenger safety Appropriations for the Indian Health Service Appropriations for Environmental Programs (including EPA) Maternal, Infant, and Early Childhood Home Visiting Program & Implementation Infant sleep product safety Lead exposure prevention Food safety Paid family and medical leave Regulation of high-powered magnet sets Vehicle emissions standards Button battery ingestions Early childhood education (including Head Start, Childcare) Child product safety and injury prevention, including drowning prevention Child Abuse Prevention and Treatment Act (CAPTA) Family First Prevention Services Act implementation Title IV-B Congregate care reform Supports for foster youth/former foster youth (including Chafee Program) Mercury and Air Toxics Standards, ozone and particulate matter NAAQS, EPA greenhouse gas regulation, Endangerment Finding QRTP/IMDs Firearm Injury and Violence Prevention (Including Research Funding; Background Checks; Safe/Secure Storage) Childcare Funding & Resources Native American Child Health Water Beads Vaccines Fluoride Child Welfare & Medicaid, Social Services Block Grant (SSBG), Temporary Assistance for Needy Families (TANF), and Supplemental Nutrition Assistance Program (SNAP) Housing Prematurity Research Expansion and Education for Mothers who Deliver Infants Early (PREEMIE) Reauthorization Act Funding Newborn Screening Saves Lives Reauthorization Act (H.R. 4709) Donor Milk, Access to Donor Milk Act Title V Maternal and Child Health (MCH) Services Block Grant SSI Savings Penalty Elimination Act (S.1234/H.R.2590) Supplemental Security Income Equality Act (H.R. 2540) Autonomous Vehicles Pregnancy Risk Assessment Monitoring System (PRAMS) Data Collection Project Toxic Substances Control Act (TSCA) & Potential Changes Family Resource Centers Infant Formula E-bikes Medicaid Payment Parity (including H.R. 1433 / S. 760 - Kids Access to Primary Care Act) Access to Care in Medicaid/CHIP Medicaid/CHIP federal funding H.R. 4641 - Keep Kids Covered Act S. 2287/H.R. 4425 - Palliative Care and Hospice Education and Training Act (PCHETA) Telehealth - Medicare telehealth extension, CONNECT for Health Act (S. 1261) One Big Beautiful Bill Act (H.R. 1) Hospital at Home Program Vaccines for Children Program S.1677/H.R.3277 - Ensuring Lasting Smiles Act (ELSA) MediKids Act Patients First Act Nutrition Infant Formula Medicaid Immigration Child Welfare Vaccines Healthcare Workforce Children and Teens Online Privacy Protection Act (H.R. 6291/S. 836) Kids Online Safety Act (H.R. 6484/S.1748) KIDS Act (H.R. 7757) Artificial Intelligence and Child Health Legislation to Protect Young People Online Funding for Title X Family Planning Program Funding for Teen Pregnancy Prevention Program Pediatric Specialty Loan Repayment Program Reauthorization, Funding, and Program Implementation Tobacco Product Regulation/Enforcement Tobacco Control Program Funding & Implementation Biomedical Research Funding (NIH, NICHD, AHRQ, etc.) Funding for NIH Environmental influences on Child Health Outcomes (ECHO) program Funding for Childrens Hospitals Graduate Medical Education (CHGME) program PDUFA Reauthorization MDUFA Reauthorization Pediatric Device Consortia Funding Pediatric Trials Network Funding Healthcare for LGBTQ Youth FY26 Labor, Health and Human Services, and Education Appropriations Bill: Pediatric Subspecialty Loan Repayment Program, Firearm Injury and Mortality Prevention Research, Pediatric Mental Health Care Access Program, Emergency Medical Services for Children, National Center for Birth Defects and Developmental Disabilities, Global Immunization, Vaccine Injury Compensation Program, Antimicrobial Resistance, Maternal and Child Health, Strengthening the Vaccines for Children Program Act IDEA Full Funding Act (H.R.2598) Artificial Intelligence Autism Vaccines Lifespan Respite Care Reauthorization Act (S.830/H.R.2560) FASD Respect Act (S. 139) Family Vaccine Protection Act (H.R.3701) VACCINE Act HEADS UP Act (H.R.3409) Protecting Free Vaccines Act PREVENT HPV Cancers Act (H.R. 6561) Vaccine Transportation Access Act Vaccine Injury Compensation Modernization Act Global Child Thrive Reauthorization Act (H.R. 6347) Fiscal Year 2027 Appropriations bills (Labor HHS and SFOPS/NSRP) Protecting Sensitive Locations Act (H.R.5166 / S.455) Early Childhood Development programming H-1Bs for the Physicians and Healthcare Workforce Act (H.R. 7961) Notice of Proposed Rulemaking on Housing and Community Development Act of 1980: Verification of Eligible Status, Docket No. FR-6524P-01 [RIN 2501-AE16] Help Separated Children Act (S.4389) Family Detention / DHS policies Unaccompanied Children's Program / Office of Refugee Resettlement Visas for International Medical Graduates National Defense Authorization Act (Mercy Amendment)

Client expense: $789,257 · Firm income: Not reported

Government targets: Administration for Children & Families (ACF), Agriculture, Dept of (USDA), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Consumer Product Safety Commission (CPSC), Drug Enforcement Administration (DEA), Environmental Protection Agency (EPA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Housing & Urban Development, Dept of (HUD), Indian Health Service, Interior, Dept of (DOI), Natl Institutes of Health (NIH), Office of the Comptroller of the Currency (OCC), SENATE, Social Security Administration (SSA), State, Dept of (DOS), U.S. Agency for International Development (USAID)

Oppose the Patients Deserve Price Tags Act (S. 2355 / H.R. 5582). The bill requires price transparency, including discounted cash price and payer-specific negotiated rates, from all imaging providers, including physician practices. Support the he H-1Bs for Physicians and the Healthcare Workforce Act (H.R. 7961), which would exempt healthcare professionals from the $100,000 H-1B petition fee

Client expense: Not reported · Firm income: $22,500

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Transparency FEMA COVID Assistance Funds Save Healthcare Workers Act, H.R.3178 Behavioral health CHGME Health care consolidation, mergers and acquisition H1-B Visas H.R. 9393, Lower Costs, More Transparency Act of 2026 H.R. 9390, Prices on the Wall Act Critical Access Hospital Relief Act (H.R. 538) Rural Hospital Support Act (S. 335) Medicare Advantage Prompt Pay Act (H.R.5454) Protect Our Hospitals Act (H.R. 4807) Resident Physician Shortage Reduction Act of 2025 (H.R. 4731/S.2439) H-1Bs for Physicians and the Healthcare Workforce Act (H.R. 7961) Tax Exempt Hospital Transparency Act (H.R. 9504)

Client expense: $70,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Monitor federal issues and legislation associated with health care policy. Monitor federal and legislative activity related to Medicare reimbursement. Monitor federal and legislative activity related to drug pricing. Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act (HR 929 / S 266) Medicare Patient Access and Practice Stabilization Act (HR 879/ S.1640) Reducing Medically Unnecessary Delays in Care Act (HR 2433) Resident Education Deferred Interest (REDI) Act (HR 2028 / S 942) Help Ensure Lower Patient (HELP) Copays Act (S. 864) Patients Before Middlemen Act (S. 882) PBM Transparency Act (S. 526) Prescription Pricing for the People Act (S. 527) Conrad State 30 and Physician Access Reauthorization Act (HR 1585 / S 709) Resident Physician Shortage Reduction Act (HR.3890/S. 2439) Improving Seniors Timely Access to Care Act (S. 1816/HR. 3514) One Big Beautiful Bill Act (HR. 1) Safe Step Act (HR 5509/S. 668) Patient Access to Autoimmune Treatment, PAAT, Act (HR. 5467) Protecting Patient Access to Cancer and Complex Therapies Act (HR 4299) PBM Reform Act of 2025 (HR 4317) Workforce Mobility Act (S.2031) Specialty Physicians Advancing Rural Care, SPARC, Act (H.R 4681/S. 1380) Connect for Health Act of 2025 (HR 2406/S. 1261) Telehealth Modernization Act (HR 5081/S 2709) House Concurrent Res. 14 establishing congressional budget for FY2025 Department of Labor, HHS, and Education Appropriations Act (S. 2587) Department of Defense Appropriations Act (HR 4016/S. 2572) Seniors Deserve SMARTER Care Act (HR 5940) A bill to require private plans to provide for e-prior auth for drugs (S. 4349) Patient Access to Higher Quality Health Care Act (HR 4002) Biosimilar Red Tape Elimination Act (HR 5526/S. 1954) Medical Foods and Formulas Access Act (HR 5684) Physician Led and Rural Access to Quality Care Act (HR 2191/S. 1390) Claims Data Act, H.R. 4331 Rural Residency Planning and development Act of 2025, H.R. 6468 To exempt H-1B health care workers from the restriction under the Presidential Proclamation entitled "Restriction on Entry of Certain Nonimmigrant Workers", and for other purposes, H.R. 7961 Provider Reimbursement Stability Act, H.R. 8163 PBM Fiduciary Accountability, Integrity, and Reform (FAIR) Act, S.3549 Chronic Care Management Act of 2026ﾠHR 8261 Prior Authorization Reform for Autoimmune & Blood Disorders ActﾠHR 9192 Patient Access to Autoimmune Treatments ActﾠHR 5467

Client expense: $180,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Monitor federal issues and legislation associated with health care policy. Monitor federal and legislative activity related to Medicare reimbursement. Monitor federal and legislative activity related to drug pricing. Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act (HR 929 / S 266) Medicare Patient Access and Practice Stabilization Act (HR 879/ S.1640) Reducing Medically Unnecessary Delays in Care Act (HR 2433) Resident Education Deferred Interest (REDI) Act (HR 2028 / S 942) Help Ensure Lower Patient (HELP) Copays Act (S. 864) Patients Before Middlemen Act (S. 882) PBM Transparency Act (S. 526) Prescription Pricing for the People Act (S. 527) Conrad State 30 and Physician Access Reauthorization Act (HR 1585 / S 709) Resident Physician Shortage Reduction Act (HR.3890/S. 2439) Improving Seniors Timely Access to Care Act (S. 1816/HR. 3514) One Big Beautiful Bill Act (HR. 1) Safe Step Act (HR 5509/S. 668) Patient Access to Autoimmune Treatment, PAAT, Act (HR. 5467) Protecting Patient Access to Cancer and Complex Therapies Act (HR 4299) PBM Reform Act of 2025 (HR 4317) Workforce Mobility Act (S.2031) Specialty Physicians Advancing Rural Care, SPARC, Act (H.R 4681/S. 1380) Connect for Health Act of 2025 (HR 2406/S. 1261) Telehealth Modernization Act (HR 5081/S 2709) House Concurrent Res. 14 establishing congressional budget for FY2025 Department of Labor, HHS, and Education Appropriations Act (S. 2587) Department of Defense Appropriations Act (HR 4016/S. 2572) Seniors Deserve SMARTER Care Act (HR 5940) A bill to require private plans to provide for e-prior auth for drugs (S. 4349) Patient Access to Higher Quality Health Care Act (HR 4002) Biosimilar Red Tape Elimination Act (HR 5526/S. 1954) Medical Foods and Formulas Access Act (HR 5684) Physician Led and Rural Access to Quality Care Act (HR 2191/S. 1390) Claims Data Act, H.R. 4331 Rural Residency Planning and development Act of 2025, H.R. 6468 To exempt H-1B health care workers from the restriction under the Presidential Proclamation entitled "Restriction on Entry of Certain Nonimmigrant Workers", and for other purposes, H.R. 7961 Provider Reimbursement Stability Act, H.R. 8163 PBM Fiduciary Accountability, Integrity, and Reform (FAIR) Act, S.3549 Chronic Care Management Act of 2026ﾠHR 8261 Prior Authorization Reform for Autoimmune & Blood Disorders ActﾠHR 9192 Patient Access to Autoimmune Treatments ActﾠHR 5467

Client expense: $180,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Monitor federal issues and legislation associated with health care policy. Monitor federal and legislative activity related to Medicare reimbursement. Monitor federal and legislative activity related to drug pricing. Dr. Lorna Breen Healthcare Provider Protection Reauthorization Act (HR 929 / S 266) Medicare Patient Access and Practice Stabilization Act (HR 879/ S.1640) Reducing Medically Unnecessary Delays in Care Act (HR 2433) Resident Education Deferred Interest (REDI) Act (HR 2028 / S 942) Help Ensure Lower Patient (HELP) Copays Act (S. 864) Patients Before Middlemen Act (S. 882) PBM Transparency Act (S. 526) Prescription Pricing for the People Act (S. 527) Conrad State 30 and Physician Access Reauthorization Act (HR 1585 / S 709) Resident Physician Shortage Reduction Act (HR.3890/S. 2439) Improving Seniors Timely Access to Care Act (S. 1816/HR. 3514) One Big Beautiful Bill Act (HR. 1) Safe Step Act (HR 5509/S. 668) Patient Access to Autoimmune Treatment, PAAT, Act (HR. 5467) Protecting Patient Access to Cancer and Complex Therapies Act (HR 4299) PBM Reform Act of 2025 (HR 4317) Workforce Mobility Act (S.2031) Specialty Physicians Advancing Rural Care, SPARC, Act (H.R 4681/S. 1380) Connect for Health Act of 2025 (HR 2406/S. 1261) Telehealth Modernization Act (HR 5081/S 2709) House Concurrent Res. 14 establishing congressional budget for FY2025 Department of Labor, HHS, and Education Appropriations Act (S. 2587) Department of Defense Appropriations Act (HR 4016/S. 2572) Seniors Deserve SMARTER Care Act (HR 5940) A bill to require private plans to provide for e-prior auth for drugs (S. 4349) Patient Access to Higher Quality Health Care Act (HR 4002) Biosimilar Red Tape Elimination Act (HR 5526/S. 1954) Medical Foods and Formulas Access Act (HR 5684) Physician Led and Rural Access to Quality Care Act (HR 2191/S. 1390) Claims Data Act, H.R. 4331 Rural Residency Planning and development Act of 2025, H.R. 6468 To exempt H-1B health care workers from the restriction under the Presidential Proclamation entitled "Restriction on Entry of Certain Nonimmigrant Workers", and for other purposes, H.R. 7961 Provider Reimbursement Stability Act, H.R. 8163 PBM Fiduciary Accountability, Integrity, and Reform (FAIR) Act, S.3549 Chronic Care Management Act of 2026ﾠHR 8261 Prior Authorization Reform for Autoimmune & Blood Disorders ActﾠHR 9192 Patient Access to Autoimmune Treatments ActﾠHR 5467

Client expense: $180,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

H.R. 1589: American Dream and Promise Act of 2025 A bill to authorize the cancellation of removal and adjustment of status of certain aliens, and for other purposes (ALL). H.R. 2627 and S. 1233: Keep STEM Talent Act of 2025 A bill to provide lawful permanent resident status for certain advanced STEM degree holders, and for other purposes (ALL). S. 2941: Visa Cap Enforcement Act A bill to discontinue certain exceptions from H-1B nonimmigrant visa numerical limitation (ALL). H.R. 8013: Keep Innovators in America Act A bill to amend the Immigration and Nationality to codify the Optional Practical Training program (ALL). H.R. 7961: H-1Bs for Physicians and the Healthcare Workforce Act A bill to exempt H-1B health care workers from the restriction under the Presidential Proclamation entitled Restriction on Entry of Certain Nonimmigrant Workers, and for other purposes (ALL). S. 4165: Educational Visa Transparency Act of 2026 A bill to require all institutions of higher education receiving Federal assistance to regularly submit information to the Student and Exchange Visitor Information System regarding students, faculty, and administrators who are not United States citizens, or lawful permanent residents (ALL). Presidential and executive actions on immigration. Presidential and executive actions on international student and scholar visas.

Client expense: $80,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 7961, Physicians and the Healthcare Workforce Act, all provisions; DRAFT, Issues pertaining H-1B visa program; Immigration, Proposed H1-B Visa Program changes and impact to health care workforce.

Client expense: $4,470,000 · Firm income: Not reported

Government targets: Bureau of Citizenship & Immigration Services (BCIS), HOUSE OF REPRESENTATIVES, Homeland Security, Dept of (DHS), SENATE

H.R. 4581 / S.2372, 340B PATIENTS Act, all provisions; H.R. 3178 / S. 1600, The Save Healthcare Workers Act, all provisions; H.R. 929 / S. 266, Dr. Lorna Breen Health Care Provider Protection Reauthorization Act, all provisions; H.R. 1585 / S. 709, Conrad State 30 and Physician Access Reauthorization Act, all provisions; S. 1874, Title VIII Nursing Workforce Reauthorization Act, all provisions; S. 2169, Rural Hospital Cybersecurity Enhancement Act, all provisions; H.R. 5283 / S. 2759, Healthcare Workforce Resilience Act, all provisions; S. 3315, Health Care Cybersecurity and Resiliency Act of 2025, all provisions; H.R. 5256, 340B Access Act, all provisions; S. 2355 / H.R. 5582, Patients Deserve Price Tags Act, all provisions; H.R. 7961, Physicians and the Healthcare Workforce Act, all provisions; S. 3435 / H.R. 6607, The Future Advancement of Academic Nursing, all provisions; S. 4637, Physician Workforce Optimization Act, all provisions; S.3788 / H.R. 8269, Consumer Labeling for Enhanced API Reporting and Legitimate Accountability for Base Entity Listings Act, all provisions; DRAFT, Issues pertaining to post-market surveillance of devices; S.Res.230, A resolution supporting the goals and ideals of National Hospital Week, to be observed from May 11 through May 17, 2025, all provisions; DRAFT, Issues pertaining to medical debt; S. 4568 / H.R. 8691, Nursing is a Professional Degree Act, all provisions; S.J. Res 196, A joint resolution providing for congressional disapproval under chapter 8 of title 5, United States Code, of the rule submitted by the Department of Education relating to "Reimagining and Improving Student Education-Federal Student Loan Program Final Regulations", all provisions; H.R. 6718, Professional Student Degree Act, all provisions; DRAFT, Lower Costs More Transparency Act of 2026, all provisions; DRAFT, To amend title XXVII of the Public Health Service Act to require hospitals to post prices on the walls, all provisions; DRAFT, To amend title XXVII of the Public Health Service Act and title XVIII of the Social Security Act to ensure health insurer accountability through publishing of overhead costs and claim payments, all provisions; DRAFT, To amend title XVIII of the Social Security Act and title XXVII of the Public Health Service Act to require the displaying of claim denial rates, all provisions; DRAFT, To amend title XI of the Social Security Act to require mandatory reporting with respect to certain health-related ownership information, all provisions; S. 1482, National Nursing Workforce Center, all provisions; S. 4027, Healthy Competition for Better Care Act, all provisions; H.R. 5629, To provide that the final rule of the Department of Health and Human Services titled Medications for the Treatment of Opioid Use Disorder, except for the portion of the final rule relating to accreditation of opioid treatment programs, shall have no force or effect; all provisions; H.R. 8726, the Protecting Authority and Restoring Tools Necessary for Enforcement by Regulatory States Act of 2026 PARTNERS Act, all provisions; S.3364, Fast Track Healthcare Apprenticeships Act, all provisions; S.4252, WIPP Economic Assistance Assurance Act of 2026, all provisions; H.R. 4470, Removing Burdens From Organ Donation Act, all provisions; U.S. Department of Health & Human Services / Office of the National Coordinator for Health Information Technology, Issue pertaining to standardized set of data elements intended to support nationwide, interoperable electronic data exchange to help ensure consistent health information exchange throughout a patient's health care journey; Health Resources & Services Administration (HRSA), Issue pertaining a revised version of a 340B rebate model pilot program; Health Resources & Services Administration (HRSA), Issue pertaining to Eli Lilly 340B program decisions; Federal Trade Commission & Department of Justice, Issues pertaining to the effectiveness of the Hart-Scott-Rodino (HSR) premerger notification form and implications for hospital field; Enhanced Premium Tax Credits, Extension of Enhanced Premium Tax Credits; Rural Health Care Access, Issues to protect access to rural health care; 340B Program, Issues pertaining to protecting 340B Program, including 340B Rebate Model Pilot Program; Maternal and Child Health, Access to maternal and child health care and addressing related workforce shortages, conditions of participation (COP); Behavioral Health, Issues related to expanding access to care and reducing regulatory barriers; Workforce, Issues pertaining to workforce development programs, supporting health care workforce and physician shortages, loan repayment programs for providers in rural and underserved areas, Graduate Medical Education program; Health Plan Accountability, Issues specific to prior authorization, patient access to care, adequate provider networks, inappropriate denials, reducing account receivables, prompt pay, white-bagging and brown-bagging policies; Health Care Resiliency & Preparedness, Issues pertaining to natural disasters, strengthen health care cybersecurity, cybersecurity workforce, and securing drug supply chains, hospital preparedness program, PAHPA reauthorization; Healthcare Price Transparency, Issues related to health care price transparency; Affordability, Issues and policy solutions pertaining to health care affordability and rising costs of health care; Tax-exempt status, Issues pertaining to not-for-profit hospitals' tax exempt status and tax-exempt private activity bonds; Immigration, Proposed H1-B Visa Program changes and impact to health care workforce; AI in Healthcare, Issues pertaining to the use of AI in healthcare; Professional Degree Program Changes, Issues pertaining to new student loan borrowing limits and professional degree programs changes; Drug Prices, Issues pertaining to lowering drug prices, securing drug supply chain, and transparency; Rural Health Transformation Fund, Issues pertaining to implementation of the Rural Health Transformation program.

Client expense: $4,470,000 · Firm income: Not reported

Government targets: Education, Dept of, Federal Trade Commission (FTC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Justice, Dept of (DOJ), SENATE

H.R. 7961: H-1Bs for Physicians and the Healthcare Workforce Act; provisions related to waiving $100,000 H-1 B Visa filing fee

Client expense: $40,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Oppose September 19 Presidential Proclamation imposing $100,000 fee on employers petitioning for new H-1B visas; support health care sector exemption; endorse H-1Bs for Physicians and the Healthcare Workforce Act (H.R. 7961). Discuss H.R.1689, designating Haiti for Temporary Protected Status, with Congressional staff.

Client expense: $580,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Nursing Home Reform (Better Way) Appropriations related outreach Support of the 21st Century Long-Term Care Caucus Outreach to DOL in Support of LTC Apprenticeships Programs Workforce Related Matters Advocacy around Observations Stays Advocacy around LTC workforce and AL with Senate Aging Committee DOL, Employment and Training - National Apprenticeship Enhancements Train More Nurses Act The American Apprenticeship Act Strengthening Pathways to Health Professions Act Freedom to Invest in Tomorrows Workforce Act States Handling Access to Reciprocity for Employment (SHARE) Act Improving Care and Access to Nurses (I CAN) Act Certified Nursing Assistant (CNA) Workforce Improvement Act The Caring for Seniors Act National Nursing Workforce Center Act Care Across Generations Act HR 1, One Big Beautiful Act Health Care Workforce Expansion Act (S. 2954) The Pathways to Health Careers Act (H.R. 5370) Healthcare Workforce Resilience Act (S. 2759/H.R. 5283) Essential Workers for Economic Advancement Act (H.R. 5494) National Nursing Workforce Center Act (S. 1482/H.R. 4407) Freedom to Invest in Tomorrows Workforce Act (Provisions of bill signed into law in reconciliation package - H.R. 1) Following TPS, H-1B and other immigration related updates from Hill and Admin Health Care Workforce Expansion Act (S. 2954) Physicians and the Healthcare Workforce Act (H. R. 7961) Department of Education NPRM, which includes a proposed change to the definition of what counts as a professional degree Dr. Lorna Breen Health Care Provider Protection Reauthorization Act (H.R. 929/S. 266) Physical Therapist Workforce and Patient Access Act (H.R. 5621) Enhancing Skilled Nursing Facilities Act (H.R. 7106) Healthcare Workforce Resilience Act (S. 2759/H.R.5283) Train More Nurses Act (S. 547/H.R.5052) Dept of Education Final Rule on Student Loan Program DOL Overtime Rule DOL Joint Employer Rule under FSLA Workforce Housing Tax Credit Act (H.R.8626) The Apprenticeship Data Value Improvements to Create Employment (ADVICE) Act The Streamlining Timely Apprenticeship Registration and Transparency (START) Act

Client expense: $840,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), SENATE, State, Dept of (DOS)